drugs management in endodontic therapy
TRANSCRIPT
![Page 1: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/1.jpg)
DRUGS MANAGEMENT IN ENDONDONTIC THERAPY
KIM HOSPITALLA NGOC HOAI LONG, DDS
![Page 2: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/2.jpg)
DRUGS
1. ANTIBIOTICS.2. ANAGESICS3. STEROIDS
![Page 3: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/3.jpg)
1. ANTIBIOTICS
![Page 4: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/4.jpg)
Antibiotics are not effective for teeth with Irreversible Pulpitis
ANTIBIOTIC do not reduce pain
A Cochrane systematic review finds no evidence to support the use of antibiotics for pain relief in irreversible pulpitis.Keenan JV1, Farman AG, Fedorowicz Z, Newton JT.
![Page 5: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/5.jpg)
Antibiotics Indications1. Systemic involvement ( Fever, Cellulitis, Lymphadenopathy)2. Medical compromised / Complex patient
Antibiotic are unnecessary for pain and localized swelling
![Page 6: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/6.jpg)
Apical lesions of pulpal origin generated by
THE IMMUNE SYSTEMIn most situations, this inflammatory process successfully eliminates bacteria emerging from the apical foramen and prevents their spread to the periapical tissue.
AAE collegues for Excellence Winter 2002
![Page 7: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/7.jpg)
ZONES OF FISH
![Page 8: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/8.jpg)
![Page 9: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/9.jpg)
![Page 10: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/10.jpg)
Antibiotic Decision Making. First choice: Penicillin 500mg qid
If no respond in 72 hours then use • Clindamycin 300mg qid• Add Metronidazole 500mg qid• Penicillin + Betalactamase ( Augmentin 625 mg tid)
If patient is allergy to penicillin First drug of choice: Clindamycin 300mg qid If no respond in 72 hours then use
Azithromycin 250mg qi NOTE: Prescribe at least for 5-7 days to prevent antibiotic resistance.
![Page 11: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/11.jpg)
2. Analgesics The pain relief afforded by endodontic treatment is effective but rarely
immediate and compete. Post treatment pain is usually mild in nature rarely lasts longer than 72h
and usually well managed with NSAIDs agent or Acetaminophen. Up to 80% patients report preoperative pain, continute to experience
some level of pain following endodontic procedure.
Consideration of steroid for endodontic painArticle in Endodontic Topics 3(1):41 - 51 · November 2002
![Page 12: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/12.jpg)
Analgesics decision making
650-1000mg Acetaminophen q6h
Acetaminophen with Codein q6h
Acetaminophen with Hydrocodone q6h
Acetaminophen with Oxyconden q6h
Mild
Severe
![Page 13: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/13.jpg)
NSAIDS
Drug choice due to inflammatory etiology of dental pain
Contraindications for Pregnancy. Ulcers Kidney disease. Ulcerative colitis
![Page 14: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/14.jpg)
![Page 15: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/15.jpg)
ACETAMINOPHEN
Drug of choice when NSAIDs are contraindicated.
![Page 16: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/16.jpg)
STEROID
Steroid have widespread on many organs system but these effects are typical only seen at supra-physiological doses given over long-time period.
Normally over 2 weeks.
Consideration of steroids for endodontic painMarshall, J. Gordon.
Endodontic Topics, Volume 3, Number 1, November 2002, pp. 41-51(11)
![Page 17: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/17.jpg)
When should I prescribe Steroids
600-800 mg Ibuprofen + 500mg Acetaminophen = Non-effective. Persistant pain lasts longer than normal Vital or Necrotic pulp
![Page 18: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/18.jpg)
Contraindications for Steroid
Systemic Fungal Infection Immune Deficiency
![Page 19: Drugs management in endodontic therapy](https://reader035.vdocuments.mx/reader035/viewer/2022062412/58ef87f21a28ab81388b458f/html5/thumbnails/19.jpg)
How should it be prescribed/doses
48mg Methylprednisolone/ day for 3 days 10-12mg Dexamethasone/ day for 3 days.